Healthcare Provider Details

I. General information

NPI: 1952813503
Provider Name (Legal Business Name): SUNSHINE BEHAVIORAL HEALTH CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2017
Last Update Date: 08/03/2021
Certification Date: 07/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18125 HIGHWAY 43
MOUNT VERNON AL
36560-6415
US

IV. Provider business mailing address

18125 HIGHWAY 43
MOUNT VERNON AL
36560-6415
US

V. Phone/Fax

Practice location:
  • Phone: 251-545-6398
  • Fax:
Mailing address:
  • Phone: 251-545-6398
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number3669
License Number StateAL

VIII. Authorized Official

Name: TRULY N. POLLARD
Title or Position: EXECUTIVE DIRECTOR
Credential: LPC
Phone: 251-414-3599